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KMID : 1039620130030010058
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Korean Journal of Family Practice
2013 Volume.3 No. 1 p.58 ~ p.64
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Symptoms and Initial Diagnostic Test in Colorectal Cancer Patients
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Kim Young-Zu
Kim Joon-Hoi
Lee Jae-Young
Park Si-Eun
Choi Jeong-MIn
Park Young-Gyu
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Abstract
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Background: In Korea, colorectal cancer incidence is increasing. Colorectal cancer was designated as one of the five national cancer screening items in Korea. Fecal occult blood test is recommended for patients over 50 years of age as a screening test. We investigated how colorectal cancer patients were diagnosed in the real-life clinical setting and examined its clinical signifi cance in primary care.
Methods: A total of 120 colorectal cancer patient subjects were enrolled during the period January 1, 2009 to December 31, 2011 in Bundang Jesaeng General Hospital. Proximal cancer from splenic fl exure was defi ned as right colon cancer and distal cancer was defi ned as left colon cancer. Chief complaints, associated symptoms and signs were reviewed using medical records, sorted by cancer position, and categorized gastrointestinal or systemic symptoms. Diagnostic tests showing abnormal results initially were analyzed by cancer position.
Results: Right colon cancer patients included 30 subjects (25.0%) and left colon cancer patients included 90 subjects (75.0%). The most common gastrointestinal symptom was abdominal pain (40.0%) in right colon cancer and bleeding (50.0%) in left colon cancer. There was a statistical difference in main gastrointestinal symptoms according to cancer position (P<0.001). Nineteen subjects (15.8%) were diagnosed through a screening program. When the patient’s main symptom was abdominal pain, computed tomography was performed. When patient’s chief complaint was bleeding, colonoscopy was preferred.
Conclusion: Symptoms and signs in colorectal cancer are various. Thorough physical exam and clinical suspicion, family physician should select the appropriate test and refer early for treatment. Because a fecal occult blood test has many limitations, early colonoscopy is recommended.
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KEYWORD
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Colorectal Neoplasms, Symptoms, Signs, Diagnostic Test, Colonoscopy
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